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Anesthesia for ERCP: Impact of Anesthesiologists Experience on Outcome and Cost

机译:ERCP麻醉:麻醉医师经验对结果和费用的影响

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摘要

The present study evaluates the effect of anesthesiologist's experience in providing deep sedation for endoscopic retrograde cholangiopancreatography (ERCP) on cost and safety. Methodology. Perioperative records of 1167 patients who underwent ERCP were divided on the basis of anesthesiologist assisting these procedures either on regular basis (Group R) or on ad hoc basis (Group N). Comparisons were made for anesthesia times, complication rates, and airway interventions. Results. Across all American Society of Anesthesiologists (ASA) Classes, regular anesthesiologists were more efficient (overall mean anesthesia time in Group R was 24.82 ± 12.96 versus 48.63 ± 21.53 minutes in Group N). Within Group R, anesthesia times across all ASA classes were comparable. In Group N, anesthesia times for higher ASA status patients were significantly longer (ASA IV, 64.62 ± 35.78 versus ASA I, 45.88 ± 11.19 minutes). Intubation rates (0.76% versus 12.8%) and median minimal oxygen saturation (100% versus 97.01%) were significantly higher in Group R. Had Group R anesthesiologists performed all procedures, the hospital could have saved US $ 758536 (based upon operating room time costs). Conclusion. Experience in providing deep sedation improved patient safety and decreased the operating room turnaround time, thereby lowering operating room costs associated with these procedures.
机译:本研究评估了麻醉师的经验为内镜逆行胰胆管造影术(ERCP)提供深度镇静作用对成本和安全性的影响。方法。根据麻醉专家的协助(常规)(R组)或临时(R组)对1167例接受ERCP的患者进行围手术期记录划分。比较麻醉时间,并发症发生率和气道干预情况。结果。在所有美国麻醉医师协会(ASA)班级中,常规麻醉医师效率更高(R组的总体平均麻醉时间为24.82±12.96分钟,而N组为48.63±21.53分钟)。在R组中,所有ASA类的麻醉时间都是可比的。在N组中,较高ASA状态患者的麻醉时间明显更长(ASA IV为64.62±35.78分钟,而ASA I为45.88±11.19分钟)。 R组的插管率(0.76%对12.8%)和中位数最低氧饱和度(100%对97.01%)明显更高。如果R组麻醉师执行了所有程序,该医院本可以节省758536美元(根据手术时间)费用)。结论。提供深层镇静的经验改善了患者的安全性,并减少了手术室的周转时间,从而降低了与这些手术相关的手术室成本。

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